End-Stage Renal Disease (ESRD) hemodialysis (HD) patients experience a variety of symptoms as a result of both the disease and its treatment. Research to date has focused on the occurrence of these symptoms, but has neglected to investigate how and to what extent they are relieved. This is significant, in that clinical observations suggest that ESRD patients often suffer from unrelieved symptoms to the detriment of their quality of life (QOL). Therefore, the overall purpose of this study is to document the prevalence of unrelieved symptoms and to determine whether there is a need for improved symptom management in the ESRD HD population. The specific aims that guide this study are: 1) to identify patient characteristics that predict high levels of symptom experience; 2) to describe the symptom experience of ESRD HD patients; 3) to describe strategies used by ESRD HD patients to manage their symptoms and the level of symptom relief achieved; 4) to describe the relationship between symptom experience and self-reported QOL; and 5) to describe the moderating effect of the level of symptom relief on the relationship between symptom experience and QOL. HD patients will complete questionnaires that tap symptom experience, level of symptom relief, and QOL. Should the need for improved symptom management be documented, further research efforts will focus on factors that contribute to inadequate symptom relief as well as interventions to improve symptom control. [unreadable] [unreadable]